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The objectives of this study were to evaluate a screening method for detecting postoperative vocal cord palsy and lower-pitched voice and to identify how a pre-thyroidectomy laryngeal disorder affects post-thyroidectomy voice change by using our subjective voice questionnaire.
We examined 300 consecutive patients scheduled to undergo thyroidectomies between November 2010 and August 2011. Laryngoscopic examination, thyroidectomy-related voice questionnaire (TVQ) administration, and acoustic and perceptual analyses were performed preoperatively and 2 weeks after thyroidectomy.
Ninety-eight (32.6 %) patients had a preoperative laryngeal disorder. Postoperatively, 31 (10.3 %) patients had vocal cord palsy and 54 (18 %) had a lower-pitched voice 2 weeks after thyroidectomy. Postoperative TVQs classified 25 (8.4 %) patients as normal and 275 (91.6 %) patients as abnormal, including 79 (26.3 %) mild, 131 (43.6 %) moderate, and 65 (21.6 %) severe cases. Of the patients with vocal cord palsy, 80.6 % belonged to the severe group, and 92.6 % of patients with lower-pitched voices belonged to the moderate and severe groups. Fundamental frequency and speaking fundamental frequency were decreased significantly in women. The most efficient TVQ cutoff values for detecting post-thyroidectomy vocal cord palsy and postoperative lower-pitched voice were 35 (87.1 % sensitivity, 79.9 % specificity) and 25 (75.9 % sensitivity, 56.5 % specificity), respectively. Total TVQ scores increased more in the nonlaryngeal than in the laryngeal disorder group.
During the early postoperative period, 28.3 % of patients had vocal cord palsy or lower-pitched voices, which could be evaluated using a simple questionnaire. Therefore, early postoperative voice evaluation is important. Patients with nonlaryngeal disorders may be more sensitive than those with laryngeal disorders to laryngeal symptoms.
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, 505 Banpodong Seochogu Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, 137-040, Korea.
This article was published in the following journal.
Name: World journal of surgery
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A pair of cone-shaped elastic mucous membrane projecting from the laryngeal wall and forming a narrow slit between them. Each contains a thickened free edge (vocal ligament) extending from the THYROID CARTILAGE to the ARYTENOID CARTILAGE, and a VOCAL MUSCLE that shortens or relaxes the vocal cord to control sound production.
The process of producing vocal sounds by means of VOCAL CORDS vibrating in an expiratory blast of air.
A disorder characterized by an intermittent abnormal VOCAL CORDS movement toward the midline during inspiration or expiration resulting in upper AIRWAY OBSTRUCTION.
A disorder in which the adductor muscles of the VOCAL CORDS exhibit increased activity leading to laryngeal spasm. Laryngismus causes closure of the VOCAL FOLDS and airflow obstruction during inspiration.
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